Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | F330146 | NY |
NPI | 1013003342 |
---|---|
Provider Name | Linda A O'connor |
First Address | New Hartford, NY 13413-9702 |
Second Address | New Hartford, NY 13413-9702 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2006 |
Last Update Date | 09/03/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F330146 | (05) | NY |
S44122 | (02) |